# Implementation of +PERTO® in Rehabilitation for Total Knee Arthroplasty: A Pilot Study

## TL;DR

A mobile app called +PERTO® helped improve recovery after knee replacement surgery by reducing pain and boosting functionality and quality of life.

## Contribution

The +PERTO® program is a novel mobile application for rehabilitation after total knee arthroplasty, showing effectiveness and high usability.

## Key findings

- The program significantly reduced pain and improved knee functionality and quality of life.
- Patients reported high satisfaction and rated the app's usability as excellent.
- Physical performance improved significantly after using the program.

## Abstract

Background/Objectives: Total knee Arthroplasty (TKA) is a prevalent treatment modality for degenerative knee diseases. Nevertheless, the success of the intervention is contingent on effective rehabilitation. The +PERTO® program (a Technological Rehabilitation Nursing Program) was developed as a mobile application comprising three phases to support patients during the perioperative period by providing exercises, information, and direct communication with healthcare professionals. The present study aims to evaluate the effects and usability of the +PERTO® program in patients undergoing total knee arthroplasty. Methods: In 2024, a hospital in northern Portugal conducted a pilot trial with eleven patients undergoing elective total knee arthroplasty. Researchers collected data both before surgery and six weeks after discharge. To evaluate effectiveness, software satisfaction, and usability, they used several assessment tools, including the Oxford Knee Score (OKS), SF-36v2, Visual Analog Scale (VAS), Short Physical Performance Battery (SPPB), QSEnf-10, and System Usability Scale (SUS). Researchers analyzed the data using both descriptive and inferential statistics. The hospital’s ethics committee and board of directors approved the study. Results: There was a significant reduction in pain (p = 0.041) and improvement in knee functionality (p = 0.010), physical performance (p = 0.038), and quality of life (p < 0.05). Patient satisfaction was high (QSEnf-10: 3.8/4), and the usability of +PERTO® was considered excellent (SUS: 96.6/100). Conclusions: The +PERTO® program proved to be an effective and innovative solution to support rehabilitation after TKA, promoting improvements in pain, functionality, and quality of life. This digital program stands out for its high rate of usability and its ability to modernize healthcare by providing a patient-centered approach.